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Compliance Rules
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0rangebear Offline

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Machine: ResMed AirSence 10
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CPAP Pressure: APAP 12.8-15 EPR 3 (cmH2O)
CPAP Software: ResScan SleepyHead

Other Comments: Ramp off

Sex: Male
Location: Brighton Colorado

Post: #1
Compliance Rules
What are these and where do they come from?

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
02-26-2016 07:33 PM
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PoolQ Offline

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Joined: Jul 2015

Machine: AirCurve 10 VAUTO
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Sex: Male
Location: Sillicon Valley

Post: #2
RE: Compliance Rules
I don't remember the total package but it's at least 4 hours? for like 90% of the time over 30 days. best I can remember but someone will correct if wrong

they are only used by insurance, including medicare, for them to pay for the machine or take it back
02-26-2016 07:37 PM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
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Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #3
RE: Compliance Rules
(02-26-2016 07:33 PM)0rangebear Wrote:  What are these and where do they come from?

Orangebear,
Medicare requires a data report from the patients (PAP) device which documents use of said device for at least 4 hours per night on 70% of nights for a 30 consecutive day period during the first 90 days after starting treatment. For example, if a patient starts (PAP) treatment on January 1st and from January 30th to February 28th they use the device every night. If 21of the 30 nights the patient used the device for at least 4 hours then they are considered to be compliant.

Medicare also requires all (PAP) patients must have a face to face visit with their physician during the second or third month of using their (PAP) device. (Between day 31 and 90 after starting on the PAP treatment) During this visit the patients physician must document an improvement of systems. This means is imperative that patients make follow up appointments to meet with their physician prior to the 90 day cut off.

Even if your not on Medicare, most insurances follow Medicare guidelines.

OpalRose
02-26-2016 07:45 PM
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PaulaO2 Offline
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Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #4
RE: Compliance Rules
The rules typically come from the insurance company. They don't want to pay for this machine without proof you are using it. They don't care if it is actually working out as adequate treatment or not, just that you are using it. Like PoolQ said, it is usually for x percentage a night for anywhere from 30 to 90 days which equal about 4hrs a night.

Sometimes an employee will want to see compliance data as well.

You cannot simply turn on a machine and let it run for 4 hrs and call it done. These newer ones can tell if a person is attached to the other end and will not count that time.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
02-26-2016 07:46 PM
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Sleeprider Online
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Posts: 3,333
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #5
RE: Compliance Rules
Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.

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02-26-2016 08:07 PM
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0rangebear Offline

Advisory Members

Posts: 341
Joined: Jan 2016

Machine: ResMed AirSence 10
Mask Type: Other
Mask Make & Model: Amara View
Humidifier: HumidAire (Built-in)
CPAP Pressure: APAP 12.8-15 EPR 3 (cmH2O)
CPAP Software: ResScan SleepyHead

Other Comments: Ramp off

Sex: Male
Location: Brighton Colorado

Post: #6
RE: Compliance Rules
(02-26-2016 08:07 PM)Sleeprider Wrote:  Ha ha! Welcome to the club. I just got my first insurance replacement since 2008 and am back on compliance monitoring. considering my minimum use is 7.5 hours and average use is over 8-hours per night, this is not a problem. Use the machine (it's good for you), and the compliance will fall right into place. At some point in the first 90 days you need to meet with your doctor and discuss this therapy and persuade him that it is benefiting you. That should not be too difficult. Do this and you're home free with your machine. Failure is not an option.

Wow! I don't knowThinking-about how you do it. I cant ever remember sleep 7.0 hour let alone 8. I am usually wide awake between 5 and 6 hours. I have tried to sleep longer just unable.

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
02-27-2016 07:37 PM
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Sleeprider Online
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Advisory Members

Posts: 3,333
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #7
RE: Compliance Rules
I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know

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02-27-2016 07:57 PM
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0rangebear Offline

Advisory Members

Posts: 341
Joined: Jan 2016

Machine: ResMed AirSence 10
Mask Type: Other
Mask Make & Model: Amara View
Humidifier: HumidAire (Built-in)
CPAP Pressure: APAP 12.8-15 EPR 3 (cmH2O)
CPAP Software: ResScan SleepyHead

Other Comments: Ramp off

Sex: Male
Location: Brighton Colorado

Post: #8
RE: Compliance Rules
(02-27-2016 07:57 PM)Sleeprider Wrote:  I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know

I envy you my friendCoffee My Dr. prescribed 5 hours a night 6 days on a week on the machine. This a bit different that the compliance stats in sleepyhead. Sounds like it must of actually come from my insurance company. I just hit my 60th day yesterday and it looks like I am on the fence on the compliance issue.

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
02-27-2016 10:37 PM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,333
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #9
RE: Compliance Rules
(02-27-2016 10:37 PM)0rangebear Wrote:  
(02-27-2016 07:57 PM)Sleeprider Wrote:  I'm such a slouch in retirement. My Sleepyhead data shows 8.42 hours average for the last year with 100% compliance. Dont-know

I envy you my friendCoffee My Dr. prescribed 5 hours a night 6 days on a week on the machine. This a bit different that the compliance stats in sleepyhead. Sounds like it must of actually come from my insurance company. I just hit my 60th day yesterday and it looks like I am on the fence on the compliance issue.

Well no wonder! You're drinking coffee late at night! Try this. Eat-popcorn

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Robysue's Beginner's Guide to Sleepyhead
02-27-2016 11:32 PM
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